World Rabies Day is Sept. 8, 2007

About one person every 10 minutes dies of rabies somewhere in the world.

This harsh statistic has brought together for the first time leaders from veterinary, animal wildlife, and human medicine to create an Alliance for Rabies Control, a non-profit group based in the United Kingdom. The group's first major happening is the declaration of World Rabies Day on Sept. 8, 2007.

The World Rabies Day coordination team is inviting partnerships with international health organizations; national, state, and local public health partners; professional organizations; commercial pharmaceutical companies; and foundations.

While much of the push is toward eradication of rabies in canine species, there is also education outreach in all areas of domestic and wild animal rabies control, with the end result of reducing the number of human rabies deaths in the world.

The Centers for Disease Control state on their Web site: "There is no treatment for rabies after symptoms of the disease appear. However, two decades ago scientists developed an extremely effective new rabies vaccine regimen that provides immunity to rabies when administered after an exposure (postexposure prophylaxis) or for protection before an exposure occurs (preexposure prophylaxis). Although rabies among humans is rare in the United States, every year an estimated 18,000 people receive rabies preexposure prophylaxis and an additional 40,000 receive postexposure prophylaxis." (For more from the CDC visit www.cdc.gov/ncidod/dvrd/rabies.)

"I recommend any animal with people contact, including horses, be vaccinated against rabies to prevent transmission to people," said Jesse Blanton, epidemiologist in charge of rabies surveillance with the Centers for Disease Control in Atlanta, Ga.

While it is difficult to get a good handle on the number of horses that die of rabies each year (all rabies cases are fatal), Blanton said there are 1,000-1,500 horses tested annually for rabies, with less than 1% positive for the disease. The unfortunate part of this is that horses often have numerous human exposures for each equine case.

"I've seen paralytic and aggressive rabid horse cases," said Blanton. "Some owners are attacked and bitten by rabid horses."

The author has only seen one confirmed case of equine rabies in nearly a half-century of working around horses. That horse was at a vet clinic in Lexington, Ky., and was under strict quarantine. The owners thought the horse had equine protozoal myeloencephalitis (EPM) because of the neurologic expression of the rabies, but the horse was confirmed with rabies. Fortunately, the clinicians were astute enough to limit exposure, and most veterinarians are vaccinated prophylactically against rabies due to their high potential for exposure.

Blanton and colleagues author the annual report for the Journal of the American Veterinary Medical Association (JAVMA) in December of each year. In December of 2006, the 2005 report was available. The summary stated, in part: "During 2005, 49 states and Puerto Rico reported 6,417 cases of rabies in nonhuman animals and 1 case in a human being to the CDC, representing a 6.2% decrease from the 6,836 cases in nonhuman animals and 8 cases in human beings reported in 2004. Approximately 92% of the cases were in wildlife, and 8% were in domestic animals. Relative contributions by the major animal groups were as follows: 2,534 raccoons (39.5%), 1,478 skunks (23%), 1,408 bats (21.9%), 376 foxes (5.9%), 269 cats (4.2%), 93 cattle (1.5%), and 76 dogs (1.2%). Compared with numbers of reported cases in 2004, cases in 2005 decreased among all groups, except bats, horses, and other wild animals." (That JAVMA article can be found here.)

There were 47 confirmed cases of rabies in horses/mules in 2005.

"The general trend for the past two or three years has been a decrease in domestic and wildlife rabies cases (in the United States)," said Blanton. "In 2006 those numbers were up, which is probably a normal cycle." The 2006 numbers will be finalized and released in December of 2007.

The World Rabies Day organization added the following general information: "Rabies is a highly neglected disease. Even though rabies in humans is 100% preventable through prompt appropriate medical care, more than 55,000 people, mostly in Africa and Asia, die from rabies every year. The most important global source of rabies in humans is from uncontrolled rabies in dogs. This major cause of rabies in humans can be eliminated. As demonstrated decades ago, comprehensive and coordinated rabies vaccination of dog populations will result in local extinction of dog-associated strains or types of rabies viruses, especially if coupled with population management and novel approaches for hard-to-reach animals. When rabies is eliminated in the main animal reservoir, human exposures from this source no longer occur.

"The personal impact of rabies can be enormous, as the bite of a rabid dog can lead to months of anxiety while victims are unsure as to whether rabies may develop. This is particularly true for poor people living in rural areas of Africa and Asia where post-exposure vaccines and immunoglobulin may not be available and are very expensive. Children are often at greatest risk from rabies as they are more likely to be bitten by dogs, and are also more likely to be bitten in high-risk sites on the body, such as the head and neck. Also, because rabies affects the brain, its victims often have frightening symptoms starting several weeks to months after an exposure. A person may feel strange sensations at the site of the bite from a rabid animal, hallucinations, difficulty swallowing, and probably most notoriously, hydrophobia (fear of water)--all of which lead quickly to death--there is no known medical cure once clinical signs of rabies are present. The bite of rabid animals often causes terrible injuries even if rabies itself can be prevented by effective post-exposure prophylaxis."

"In addition, rabies is a concern for animal welfare. Fear of the disease may result in hostile and antagonistic attitudes towards dogs and often inhumane approaches to rabies control among dogs in a community. Also, rabies poses an immediate threat to several of the world's most endangered wildlife populations, such as the Florida Panther, Ethiopian Wolf, and African Wild Dog.

Hold An Event

The World Rabies Day initiative consists of inviting partners and individuals to plan and conduct a number of inaugural World Rabies Day events including runs, walks, rolls (i.e., runs including disabled persons, as well as bicycling events), concerts, festivals, educational seminars, scientific symposia, and official declaration ceremonies. "There are a number of imaginative names for planned events, including: Run Against Rabies; Run For Rabies, Run 4 Rabies Awareness; Run, Walk and Roll for Rabies Control; Swim for a Rabies-free Country, a series of "Rock and Roll for Rabies Control" fundraising concerts, and more.

There are downloadable materials available for planning a World Rabies Day event. See worldrabiesday.org/campaign_en.php for a Course Planning Guide (PDF), Fundraising Guide (PDF), Event Sign In Sheet (PDF), and an Event Signage (PPT).

Teaching to Make Rabies History

Are you a teacher of a primary or secondary school? If so, you are asked to join the rabies campaign to educate children about the causes of rabies and how it can end.

"We invite you and your students to use our downloadable education material and suggestions for activities to Make Rabies History by participating in this inaugural World Rabies Day. See worldrabiesday.org/campaign_en.php for Learning to Make Rabies History Curriculum (PowerPoint), Learning to Make Rabies History Curriculum (PDF), and Commemorations to Make Rabies History.

The World Rabies Day initiative invites individuals and groups of persons to commemorate persons, especially loved ones, who have died of rabies through the observation of 55 seconds of silence--one second for each 1,000 persons per year whose death from rabies could have been prevented.

Donation for Eradication"Rabies is a terrible disease that kills around 100 children a day in Africa and Asia, and which causes considerable suffering for people and their animals," noted the organization. If you would like to support this initiative financially visit worldrabiesday.org/donate_en.php. If you would like to purchase T shirts or other items with the World Rabies Day logo, visit worldrabiesday.org/shop_en.php.

More will be added to the World Rabies Day Web site in the upcoming weeks.

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